糖化血红蛋白监测对冠心病合并糖尿病患者血糖控制的影响  

Clinical Significance of HbA_(1c) Monitoring in Glycaemic Control in Diabetes Patients Complicated with Coronary Artery Disease

作　　者：张晓霞[1] 米树华[1] 池喆[1] 陈青[1] 戴文龙[1] 李菁[1] 

机构地区：[1]首都医科大学附属北京安贞医院特需医疗科,北京市100029

出　　处：《中国全科医学》2011年第20期2251-2252,2256,共3页Chinese General Practice

摘　　要：目的探讨合并糖尿病的冠心病患者血糖控制状况的影响因素。方法连续入选符合本研究入选标准的406例冠心病合并糖尿病患者,通过电话随访完成相关调查问卷。所有患者随访至2009年9月—2010年7月。除近3个月内有明确记录者外,均门诊检测糖化血红蛋白(HbA1 c),并根据其结果将患者分为血糖控制达标组和未达标组。比较两组患者临床资料及出院后诊疗状况,分析影响血糖控制的因素。结果共320例患者完成随访,随访率78.8%,平均随访时间21.2个月。HbA1 c达标率为47.8%。血糖控制良好的相关因素包括:冠状动脉三支血管病变、规律运动、定期检测HbA1 c及了解血糖控制目标值。多因素分析显示,定期检测HbA1 c是改善患者血糖控制的最有效措施(OR=3.99)。结论合并糖尿病的冠心病患者血糖控制状况尚不理想,监测HbA1 c可有效改善血糖控制达标率,应引起临床医生的重视。Objective To investigate the influencing factors of glycaemic control in diabetes patients with complicated coronary artery disease（CAD）.Methods A total of 406 patients were consecutively enrolled.Questionnaires were completed via telephone interview and patients were followed from September,2009 to July 2010.HbA1c levels were examined and the subjects were divided into two groups accordingly：the group who had reached the standard of glycaemic control and elsewise.Clinical data and diagnosis-and-treat after discharge were compared between the two groups to analyze influencing factors of glycaemic control.Results The follow-up were completed in 320（78.8%） patients,with an average follow-up duration of 21.2 months.Rate of patients who reached the standard of glycaemic control was 47.8%.Correlated factors of better glycaemic control were：3-vessel lesion,regular exercises,regular HbA1c examinations,and knowledge of the aim of glycaemic control.Multi-factor logistic regression analysis showed that HbA1c monitoring was the most effective measure to improve the glycaemic control.Conclusion HbA1c monitoring is an effective measure to improve the glycaemic control and deserve the attention of clinicians.

关 键 词：冠心病 糖尿病 血红蛋白A 糖基化 

分 类 号：R587.1[医药卫生—内分泌]